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What options are there for weight loss medications?

Medically reviewed by Carmen Pope, BPharm. Last updated on March 23, 2023.

Melody L. Berg

PharmD, BCPS, MPH

Nearly two-thirds of adults in the United States are overweight. Although many overweight people are concerned about their appearance, more importantly, excess weight can impact your health. Carrying around extra pounds can cause or worsen many medical conditions like high blood pressure, diabetes, and heart disease. Your pharmacist can be a valuable resource for providing information about lifestyle changes and weight loss medications.

What should I do if my doctor tells me that I should lose weight?

If your doctor or other healthcare professional wants to talk about your weight, be assured it is from a medical concern for your health and not a judgment of your appearance. To lose pounds and maintain weight loss, most people require support and having a care team of experts will improve your results. This team may include your doctor, a dietician to guide your food choices, a nurse, an exercise coach, and your pharmacist.

Special care is necessary for children, older adults, and for women to manage weight during pregnancy. And if you are discouraged by the thought of trying to lose a lot of weight, experts have found that even a 5-10% weight loss can significantly improve your health.

How can I lose weight?

Your care team will outline a plan for your weight loss that not only includes a healthy diet and exercise but may also will address behavioral issues and other risk factors listed below that have been identified in clinical studies to be associated with obesity.

  • Avoiding physical activity
  • Consuming soft drinks and other sweet beverages
  • Eating fast food
  • Not having family meals together (children and teens)
  • Skipping breakfast
  • Watching TV (4 or more hours per day compared to 1 hour)
  • Using food as a reward
  • Certain medications that cause weight gain

Regular check-ins and other monitoring of progress with your care team are key to achieving successful weight loss goals.

What if I have made lifestyle changes and I'm still not losing weight?

Your doctor or pharmacist may determine that in addition to addressing nutrition, physical activity, and behavioral changes, you may benefit from medications, medical devices, or bariatric (weight loss) surgery to manage your obesity.

Most medications for the management of weight loss must be prescribed by your doctor. Before you begin to take any medication for weight loss, be sure to ask your doctor or pharmacist about any side effects that may occur. Tell them if you are pregnant, planning to get pregnant, or are breastfeeding.

Medications for weight loss include:

  • Orlistat (Xenical) decreases the absorption of fat from food.
  • Lorcaserin (Belviq XR) affects a specific serotonin receptor in the appetite center of the brain.
  • Phentermine-topiramate ER (Qsymia) – Each of these medications has been used to promote weight loss, but together can cause greater weight loss at lower doses.
  • Naltrexone-bupropion SR (Contrave) – Each of these medications have been used to promote weight loss, but when used together can cause greater weight loss.
  • Liraglutide (Saxenda) injection and semaglutide (Ozempic) injection were originally approved for the treatment of type 2 diabetes. Wegovy is FDA-approved specifically for weight loss. These medications affect the appetite center of the brain.

A lower dose of the prescription medication, orlistat (Alli), is available without a prescription. Most over-the-counter (OTC) medications and herbal supplements (including those you purchase online) do not have proven safety and effectiveness for weight loss. Always check with your pharmacist before considering one of these products.

For people with significant obesity and at least one obesity-related medical condition, a doctor may recommend surgery or the use of a medical device to aid in weight loss. Bariatric surgery for weight loss reduces the space in your stomach to restrict food intake. Bypass surgery limits the absorption of food to decrease calorie intake. A medical device, the gastric balloon, can be inserted into the stomach to restrict food intake.

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Summary

From lifestyle changes to medications or even surgery, there are many options available to help you lose weight. Your pharmacist is a medication expert who can provide information about prescription and OTC weight loss products and make recommendations for healthy lifestyle modifications.

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AHFS® Patient Medication Information is used with permission. ©2024, the American Society of Health-System Pharmacists, Inc. (ASHP). The ASHP Data is a part of the AHFS Drug Information®️; ASHP is not responsible for the accuracy of transpositions from the original context.